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Background: Implant rehabilitation in cases of monoedentulism in the esthetic area is a challenge for the clinician. The aim of our study was to test the diagnostic–therapeutic accuracy of computer-guided implant placement in the esthetic area. Methods: Postimplant surgery cone beam computed tomography (CBCT) scans were retrospectively analyzed to assess the accuracy of computer-guided implant placement compared to the preoperative computer-digital planned implant position. We selectively enrolled CBCT scans of patients who underwent immediate or delayed implant placement of a single maxillary incisor, treated with computer-guided implant surgery through a tooth-supported digitally designed 3D printed guide. Our analysis consisted of three digital measurements: the mean deviation of the implant axis, and the mean mesiodistal implant deviation measured both at the apex and at the head of the implant. Results: A total of 95 implants were placed in 95 patients (60 Males, 35 Females; age from 27 to 45-year-old). Congruence analysis showed a mean deviation of implant axis of 1.04° ± 0.56° in sagittal projection, a mean mesiodistal implant deviation between adjacent teeth of 0.14 mm ± 0.07 mm at implant head level and 0.8 mm ± 0.3 mm at the apex in axial projection. Conclusions: computer-guided implant placement through a tooth-supported guide was extremely accurate in the esthetic area because the deviations between the real implant position and the preoperative planning was not clinically relevant. Full article